title: Risk of hemoptysis in patients with resected squamous cell and other high-risk lung cancers treated with adjuvant bevacizumab.
abstract: OBJECTIVE
  Bevacizumab improves survival in lung adenocarcinomas. The potential anti-tumor benefit of bevacizumab in squamous cell lung cancers (SQCLCs) is unknown because bevacizumab is contraindicated in patients with advanced SQCLC due to an increased risk of hemoptysis. The risk of hemoptysis may be eliminated in patients with resected SQCLCs. We evaluated the safety of adjuvant bevacizumab in patients with resected SQCLCs and other lung cancers at high risk of hemoptysis.
  
  
  METHODS
  As part of a prospective, phase II trial, patients with lung cancers at high risk of hemoptysis (defined by SQCLC histology, tumor near the central blood vessels, or history of hemoptysis) were treated with adjuvant bevacizumab following neo-adjuvant chemotherapy and complete surgical resection. Bevacizumab 15 mg/kg was given once every 3 weeks for up to 1 year. Patients were followed for safety and survival.
  
  
  RESULTS
  Thirteen patients with high-risk features were treated: 7 patients had SQCLC, 3 had central tumors, and 3 had previous hemoptysis. No hemoptysis of any grade was seen following treatment with bevacizumab. Five of 13 patients experienced grade 1 bleeding (epistaxis, gum bleeding). Hypertension and lymphopenia were seen.
  
  
  CONCLUSIONS
  In a cohort of patients with resected lung cancers at high risk of hemoptysis, including those with SQCLC, treatment with adjuvant bevacizumab did not result in hemoptysis of any grade.
authors.affiliation: Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical School, 300 East 66th Street, New York, NY 10065, USA.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Hellmann
authors.forename: Jamie E
authors.initials: JE
authors.lastname: Chaft
authors.forename: Valerie
authors.initials: V
authors.lastname: Rusch
authors.forename: Michelle S
authors.initials: MS
authors.lastname: Ginsberg
authors.forename: David J
authors.initials: DJ
authors.lastname: Finley
authors.forename: Mark G
authors.initials: MG
authors.lastname: Kris
authors.forename: Katharine A R
authors.initials: KA
authors.lastname: Price
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Azzoli
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Fury
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Riely
authors.forename: Lee M
authors.initials: LM
authors.lastname: Krug
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Downey
authors.forename: Manjit S
authors.initials: MS
authors.lastname: Bains
authors.forename: Camelia S
authors.initials: CS
authors.lastname: Sima
authors.forename: Nabil
authors.initials: N
authors.lastname: Rizk
authors.forename: William D
authors.initials: WD
authors.lastname: Travis
authors.forename: Naiyer A
authors.initials: NA
authors.lastname: Rizvi
authors.forename: Paul K
authors.initials: PK
authors.lastname: Paik
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects* / Q000627:therapeutic use*; D000068258:Bevacizumab; D002294:Carcinoma, Squamous Cell / Q000150:complications* / Q000188:drug therapy* / Q000601:surgery; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D023381:Endpoint Determination; D005260:Female; D006469:Hemoptysis / Q000139:chemically induced* / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D017567:Karnofsky Performance Status; D008175:Lung Neoplasms / Q000150:complications* / Q000188:drug therapy* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011182:Postoperative Care; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab